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  1. Flaws in advance directives that request withdrawing assisted feeding in late-stage dementia may cause premature or prolonged dying.Nathaniel Hinerman, Karl E. Steinberg & Stanley A. Terman - 2022 - BMC Medical Ethics 23 (1):1-26.
    BackgroundThe terminal illness of late-stage Alzheimer’s and related dementias is progressively cruel, burdensome, and can last years if caregivers assist oral feeding and hydrating. Options to avoid prolonged dying are limited since advanced dementia patients cannot qualify for Medical Aid in Dying. Physicians and judges can insist on clear and convincing evidence that the patient wants to die—which many advance directives cannot provide. Proxies/agents’ substituted judgment may not be concordant with patients’ requests. While advance directives can be patients’ last resort (...)
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  • The Voice Is As Mighty As the Pen: Integrating Conversations into Advance Care Planning.Kunal Bailoor, Leslie H. Kamil, Ed Goldman, Laura M. Napiewocki, Denise Winiarski, Christian J. Vercler & Andrew G. Shuman - 2018 - Journal of Bioethical Inquiry 15 (2):185-191.
    Advance care planning allows patients to articulate preferences for their medical treatment, lifestyle, and surrogate decision-makers in order to anticipate and mitigate their potential loss of decision-making capacity. Written advance directives are often emphasized in this regard. While these directives contain important information, there are several barriers to consider: veracity and accuracy of surrogate decision-makers in making choices consistent with the substituted judgement standard, state-to-state variability in regulations, literacy issues, lack of access to legal resources, lack of understanding of medical (...)
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